心力衰竭患者的临床特征、管理方法及预后：约旦心力衰竭注册研究
Clinical characteristics, management approaches, and outcomes of patients with heart failure: the Jordan Heart Failure Registry.
作者信息
Abu-Hantash Hadi, Khader Yousef, Al-Saleh Akram, Al-Makhamreh Hanna, Ibdah Rasheed, Ababneh Muhannad, Nammas Asem, Rasheed Amr, Toubasi Ahmad, Al-Qalalweh Sarah, Mahmoud Mohammad Y, Albustanji Farah, Obaid Yazan Y, Abu Tawileh Hind B, Awaisheh Toqa, Elias Hobeika Louis, Banihamdan Ala, Al-Kasasbeh Abdullah, Rawashdeh Sukaina, Abu-Hantash Mohammad, Shakhatreh Ali, Izraiq Mahmoud
机构信息
Department of Cardiology, Amman Surgical Hospital, Amman, Jordan.
Department of Cardiology, Jordan University of Science and Technology, Irbid, Jordan.
出版信息
Front Cardiovasc Med. 2025 Jul 28;12:1592002. doi: 10.3389/fcvm.2025.1592002. eCollection 2025.
BACKGROUND
Heart failure (HF) is a complex clinical syndrome with diverse etiologies and pathophysiological mechanisms. While chronic HF has gained substantial understanding, acute HF remains less elucidated. This study aimed to analyze the data from the Jordanian Heart Failure Registry (JoHFR) to assess the clinical characteristics, management approaches, and outcomes of patients with HF.
METHODS
The study included data from 21 healthcare centers from private sector clinics and hospitals and public secondary and tertiary university hospitals across Jordan from July 1, 2021, to February 28, 2023. It included patients above the age of 18 with chronic HF, acute decompensated HF , or acute on top of chronic HF. Data encompassed patient demographics, comorbidities, medications, clinical presentation, laboratory findings, echocardiograms, and outcomes.
RESULTS
A total of 2,151 patients were enrolled. More than half (58.0%) of the study cohort were males. The mean age of patients was 66 years, with almost half of the patients (45.5%) aged 70 or older. Chronic HF accounted for 71% of cases, while acute HF constituted 29% of cases. Obesity was identified in 36.6% of the cohort. Hypertension (80.7%) and a history of atherosclerotic cardiovascular disease (ASCVD) (80.6%) were the most prevalent comorbidities. Beta-blockers were the most commonly prescribed medications (67.4%). RAAS inhibitors including ACE inhibitors (18.1%), ARBs (25.2%), and ARNI (10.8%), were also frequently used. Dyspnea (85.9%) was the most common presenting symptom, and elevated B-type natriuretic peptide levels were well utilized and observed in most patients (96.7%). Left ventricular ejection fraction (LVEF) was ≤40% in 58.8%, 41%-49% in 11.4%, and ≥50% in 29.7% of patients, with a mean (SD) of 38.1% (12.7%). The in-hospital mortality rate in our registry stood at 9.6%.
CONCLUSION
The Jordan Heart Failure Registry (JoHFR) presents the unique characteristics of both chronic and acute HF patients in Jordan and highlights areas for improving patient care and adherence to international guidelines. These findings should guide healthcare policymakers and practitioners in the country to enhance the quality of management of HF patients and implement interventions to reduce the burden of comorbidities accompanying HF.
背景
心力衰竭（HF）是一种病因和病理生理机制多样的复杂临床综合征。虽然慢性心力衰竭已得到充分认识，但急性心力衰竭仍了解较少。本研究旨在分析约旦心力衰竭登记处（JoHFR）的数据，以评估心力衰竭患者的临床特征、管理方法和预后。
方法
该研究纳入了2021年7月1日至2023年2月28日期间约旦私立部门诊所和医院以及公立二级和三级大学医院的21个医疗中心的数据。纳入了年龄在18岁以上的慢性心力衰竭、急性失代偿性心力衰竭或慢性心力衰竭基础上的急性心力衰竭患者。数据包括患者人口统计学、合并症、药物治疗、临床表现、实验室检查结果、超声心动图和预后。
结果
共纳入2151例患者。研究队列中超过一半（58.0%）为男性。患者的平均年龄为66岁，近一半（45.5%）的患者年龄在70岁及以上。慢性心力衰竭占病例的71%，而急性心力衰竭占病例的29%。队列中36.6%的患者存在肥胖。高血压（80.7%）和动脉粥样硬化性心血管疾病（ASCVD）病史（80.6%）是最常见的合并症。β受体阻滞剂是最常用的药物（67.4%）。包括血管紧张素转换酶抑制剂（ACE抑制剂，18.1%）、血管紧张素Ⅱ受体拮抗剂（ARB，25.2%）和血管紧张素受体脑啡肽酶抑制剂（ARNI，10.8%）在内的肾素-血管紧张素-醛固酮系统（RAAS）抑制剂也经常使用。呼吸困难（85.9%）是最常见的症状，大多数患者（96.7%）的B型利钠肽水平升高且得到充分利用和观察。58.8%的患者左心室射血分数（LVEF）≤40%，11.4%的患者LVEF为41%-49%，29.7%的患者LVEF≥50%，平均（标准差）为38.1%（12.7%）。我们登记处的住院死亡率为9.6%。
结论
约旦心力衰竭登记处（JoHFR）呈现了约旦慢性和急性心力衰竭患者的独特特征，并突出了改善患者护理和遵循国际指南的领域。这些发现应指导该国的医疗政策制定者和从业者提高心力衰竭患者的管理质量，并实施干预措施以减轻心力衰竭伴随的合并症负担。
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